The post-Francis emphasis on adequate numbers of nurses to provide safe care has been a good thing, as we’ve often said in this magazine.
However, the scramble to employ enough nurses to achieve safe staff levels and skill mix has been a challenge for many trusts.
To achieve numbers that look healthy enough to publish on the NHS Choices website, trusts from across the UK are relying on huge increases in the use of expensive agency staff (page 4) or recruiting from overseas (page 2) because there simply aren’t enough homegrown nurses to meet demand.
To those of you who have been in nursing a while, this sort of boom and bust cycle is familiar. Yet many nursing shortages are entirely predictable. For example, the fact that huge numbers of nurses are approaching retirement age is not new information, but university funding has not produced enough newly qualified nurses to replace them. As a result, directors of nursing and their deputies have had to dig out their passports and look abroad.
But is this strategy worth it? Our exclusive investigation reveals that a shockingly low proportion of migrant recruits stay with the trust that hired them - in some cases, trusts have retained none of the staff they recruited from overseas.
Our data only shows how many left their recruiting trust, but not why or where they went, so we don’t know whether they have stayed in the UK or with the NHS. However, one thing is clear: it is extremely expensive for trusts to hire overseas, and damaging to NHS finances if these recruits don’t stay long enough to provide a return on that investment. And this is only part of the problem.
A report published last week by the Royal College of Nursing calculated that NHS spending on agency staff totalled almost £1bn. Agency nurses can provide flexibility to meet fluctuating needs in the short term. But spending £980m - which the RCN says would pay for 28,155 permanent staff - seems shortsighted.
The over-reliance on international and agency staff points to one thing: we didn’t train enough nurses. We’ve been commissioning training places on the basis of affordability, not demand.
Nursing has always been an easy target for short-term cuts to balance the books. That has to stop. The Department of Health and NHS England’s strategies won’t work without nurses to deliver them.
Jenni Middleton, editor
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